Managing and sharing health data through information accountability protocols

Concerns over the security and privacy of patient information are one of the biggest hindrances to sharing health information and the wide adoption of eHealth systems. At present, there are competing requirements between healthcare consumers' (i.e. patients) requirements and healthcare professionals' (HCP) requirements. While consumers want control over their information, healthcare professionals want access to as much information as required in order to make well-informed decisions and provide quality care. In order to balance these requirements, the use of an Information Accountability Framework devised for eHealth systems has been proposed. In this paper, we take a step closer to the adoption of the Information Accountability protocols and demonstrate their functionality through an implementation in FluxMED, a customisable EHR system.

The design and implementation of an Information Accountability Framework for eHealth systems

This tutorial primarily focuses on the implementation of Information Accountability (IA) protocols defined in an Information Accountability Framework (IAF) in eHealth systems. Concerns over the security and privacy of patient information are one of the biggest hindrances to sharing health information and the wide adoption of eHealth systems. At present, there are competing requirements between healthcare consumers' (i.e. patients) requirements and healthcare professionals' (HCP) requirements. While consumers want control over their information, healthcare professionals want access to as much information as required in order to make well-informed decisions and provide quality care. This conflict is evident in the review of Australia's PCEHR system and in recent studies of patient control of access to their eHealth information. In order to balance these requirements, the use of an Information Accountability Framework devised for eHealth systems has been proposed. Through the use of IA protocols, so-called Accountable-eHealth systems (AeH) create an eHealth environment where health information is available to the right person at the right time without rigid barriers whilst empowering the consumers with information control and transparency. In this half-day tutorial, we will discuss and describe the technical challenges surrounding the implementation of the IAF protocols into existing eHealth systems and demonstrate their use. The functionality of the protocols and AeH systems will be demonstrated, and an example of the implementation of the IAF protocols into an existing eHealth system will be presented and discussed.

Defining and predicting the 'break of the season' for north-east Queensland grazing areas

For pasture growth in the semi-arid tropics of north-east Australia, where up to 80% of annual rainfall occurs between December and March, the timing and distribution of rainfall events is often more important than the total amount. In particular, the timing of the 'green break of the season' (GBOS) at the end of the dry season, when new pasture growth becomes available as forage and a live-weight gain is measured in cattle, affects several important management decisions that prevent overgrazing and pasture degradation. Currently, beef producers in the region use a GBOS rule based on rainfall (e. g. 40mm of rain over three days by 1 December) to define the event and make their management decisions. A survey of 16 beef producers in north-east Queensland shows three quarters of respondents use a rainfall amount that occurs in only half or less than half of all years at their location. In addition, only half the producers expect the GBOS to occur within two weeks of the median date calculated by the CSIRO plant growth days model GRIM. This result suggests that in the producer rules, either the rainfall quantity or the period of time over which the rain is expected, is unrealistic. Despite only 37% of beef producers indicating that they use a southern oscillation index (SOI) forecast in their decisions, cross validated LEPS (linear error in probability space) analyses showed both the average 3 month July-September SOI and the 2 month August-September SOI have significant forecast skill in predicting the probability of both the amount of wet season rainfall and the timing of the GBOS. The communication and implementation of a rigorous and realistic definition of the GBOS, and the likely impacts of anthropogenic climate change on the region are discussed in the context of the sustainable management of northern Australian rangelands.

Development of commercial application of an avocado fruit robustness test

Fruit quality is one of the major factors limiting growth in avocado retail sales. Avocado growers are often unaware of their end-use fruit quality since quality problems only manifest upon fruit ripening and growers receive limited feedback from the supply chain. If growers were aware of their expected fruit quality they would be equipped to make better marketing decisions and if necessary to take remedial actions to improve their fruit quality. Avotest is being developed as a quick and easy method of determining expected end-use fruit quality before the start of the commercial fruit harvest. The test aims at distinguishing between blocks with robust fruit and those with less robust fruit. The test could also be used to predict the resulting fruit quality after the implementation of new farming practices.

What does built environment research have to do with risk mitigation, resilience and disaster recovery?

One could argue that the nature of our housing stock is a key determining factor in the ability of our citizens to manage risk, be resilient to various natural and human events, and to recover from these events. Recent research has been examining current challenges posed by our housing stock and exploring potential solutions from a range of perspectives. The aim of this paper is to discuss key findings from recent built environment research in Australia to initiate cross-sectorial discussion and debate about the implications and opportunities for other sectors such as emergency management and insurance. Three recent building research projects are discussed: - Heat waves The impact of heat waves on houses and occupants, and proposed changes to building regulations, air conditioning standards and building design, to reduce risks associated with heat waves. - Net zero energy homes Exploration of the potential benefits of a strategic optimization of building quality, energy and water efficiency, and household or community level distributed energy and water services for disaster management and recovery. - Building information Mapping of the flow of information about residential buildings, and the potential for national or regional building files (in a similar manner to personal medical records) to assist all parties to make more informed decisions that impact on housing sustainability and community resilience. The paper discusses how sustainability, environmental performance and resilience are inter-related, and can be supported by building files. It concludes with a call for increased cross-sectorial collaboration to explore opportunities for a whole-of-systems approach to our built environment that addresses a range of economic and environmental challenges as well as disaster and emergency management.

Kuluttajamuotti : Kuluttajuuden tuottamisesta mainonnan instituutioissa

Advertising and marketing institutions produce categorisations of different groups of population. These categorisations serve as tools for addressing the potential consumers. This research is about how and what kind of categorisations of consumerhood are produced and how they are used as governing patterns within the institutions of advertising. My goal is to shed light on methods, cultural patterns and discourses for making people become consumers, objects for marketing measures. The data consists of 23 qualitative thematic interviews with Finnish advertising professionals. Moreover, examples are drawn from professional magazines and brochures of media agencies and marketing research organisations. First, I present some of the the official consumer categories in the consumer monitors produced by research organisations. Then, I analyse the unofficial consumer categories which are produced by advertising professionals in the interviews. The methodological framework is based on discourse theory and especially on Michel Foucault s ideas on power, governmentality, and discourses. Discursive categorisation of the population is one of the means of governmentality used in marketing and advertising. Knowledge of the consumer research is used as a tool for governing the potential consumers. Even though the real consumers always have a possibility to behave against the marketer s wishes. The marketers can not make people buy certain products or services, but they aim at influencing people in a way that they want to buy the products and start to govern themselves. As result, I present six unofficial discursive consumer categories, which are used by the advertising professionals. The consumerhood may be represented as rational, self-fulfilling, indifferent, whimsical, manipulated or sovereign. However, The discursive consumer categorisations are overlapping and controversial. The interviewed advertising professionals construct their own particular position in relation to the consumers which are viewed as others . On the other, the interviewees may talk about themselves as consumers. Finally, I maintain that the consumers and target groups of advertising are viewed as commodities in advertising institutions. The end product of the product development is not only the product but the aim is to produce the consumer of the product. The research of the ways advertising professionals aim to govern the consumers gives knowledge on the networks of power in which people act within consumer culture.

Error exponent analysis of energy-based Bayesian decentralized spectrum sensing under fading

This paper considers decentralized spectrum sensing, i.e., detection of occupancy of the primary users' spectrum by a set of Cognitive Radio (CR) nodes, under a Bayesian set-up. The nodes use energy detection to make their individual decisions, which are combined at a Fusion Center (FC) using the K-out-of-N fusion rule. The channel from the primary transmitter to the CR nodes is assumed to undergo fading, while that from the nodes to the FC is assumed to be error-free. In this scenario, a novel concept termed as the Error Exponent with a Confidence Level (EECL) is introduced to evaluate and compare the performance of different detection schemes. Expressions for the EECL under general fading conditions are derived. As a special case, it is shown that the conventional error exponent both at individual sensors, and at the FC is zero. Further, closed-form lower bounds on the EECL are derived under Rayleigh fading and lognormal shadowing. As an example application, it answers the question of whether to use pilot-signal based narrowband sensing, where the signal undergoes Rayleigh fading, or to sense over the entire bandwidth of a wideband signal, where the signal undergoes lognormal shadowing. Theoretical results are validated using Monte Carlo simulations. (C) 2015 Elsevier B.V. All rights reserved.

First Biennial Ocean Climate Summit: Finding Solutions for San Francisco Bay Area’s Coast and Ocean. Proceedings of the Summit: April 29, 2008, Golden Gate Club, The Presidio San Francisco, California

Executive Summary: The marine environment plays a critical role in the amount of carbon dioxide (CO2) that remains within Earth’s atmosphere, but has not received as much attention as the terrestrial environment when it comes to climate change discussions, programs, and plans for action. It is now apparent that the oceans have begun to reach a state of CO2 saturation, no longer maintaining the “steady-state” carbon cycle that existed prior to the Industrial Revolution. The increasing amount of CO2 present within the oceans and the atmosphere has an effect on climate and a cascading effect on the marine environment. Potential physical effects of climate change within the marine environment, including ocean acidification, changes in wind and upwelling regimes, increasing global sea surface temperatures, and sea level rise, can lead to dramatic, fundamental changes within marine and coastal ecosystems. Altered ecosystems can result in changing coastal economies through a reduction in marine ecosystem services such as commercial fish stocks and coastal tourism. Local impacts from climate change should be a front line issue for natural resource managers, but they often feel too overwhelmed by the magnitude of this issue to begin to take action. They may not feel they have the time, funding, or staff to take on a challenge as large as climate change and continue to not act as a result. Already, natural resource managers work to balance the needs of humans and the economy with ecosystem biodiversity and resilience. Responsible decisions are made each day that consider a wide variety of stakeholders, including community members, agencies, non-profit organizations, and business/industry. The issue of climate change must be approached as a collaborative effort, one that natural resource managers can facilitate by balancing human demands with healthy ecosystem function through research and monitoring, education and outreach, and policy reform. The Scientific Expert Group on Climate Change in their 2007 report titled, “Confronting Climate Change: Avoiding the Unmanageable and Managing the Unavoidable” charged governments around the world with developing strategies to “adapt to ongoing and future changes in climate change by integrating the implications of climate change into resource management and infrastructure development”. Resource managers must make future management decisions within an uncertain and changing climate based on both physical and biological ecosystem response to climate change and human perception of and response to the issue. Climate change is the biggest threat facing any protected area today and resource managers must lead the charge in addressing this threat. (PDF has 59 pages.)

What is coastal climate?

Historical definitions of what determines whether one lives in a coastal area or not have varied over time. According to Culliton (1998), a “coastal county” is defined as a county with at least 15% of its total land area located within a nation’s coastal watershed. This emphasizes the land areas within which water flows into the ocean or Great Lakes, but may be better suited for ecosystems or water quality research (Crowell et al. 2007). Some Federal Emergency Management Agency (FEMA) documents suggest that “coastal” includes shoreline-adjacent coastal counties, and perhaps even counties impacted by flooding from coastal storms. An accurate definition of “coastal” is critical in this regard since FEMA uses such definitions to revise and modernize their Flood Insurance Rate Maps (Crowell et al. 2007). A recent map published by the National Oceanic and Atmospheric Administration’s (NOAA) Coastal Services Center for the Coastal Change Analysis Program shows that the “coastal” boundary covers the entire state of New York and Michigan, while nearly all of South Carolina is considered “coastal.” The definition of “coastal” one chooses can have major implications, including a simple count of coastal population and the influence of local or state coastal policies. There is, however, one aspect of defining what is “coastal” that has often been overlooked; using atmospheric long-term climate variables to define the inland extent of the coastal zone. This definition, which incorporates temperature, precipitation, wind speed, and relative humidity, is furthermore scalable and globally applicable - even in the face of shifting shorelines. A robust definition using common climate variables should condense the large broad definition often associated with “coastal” such that completely landlocked locations would no longer be considered “coastal.” Moreover, the resulting definition, “coastal climate” or “climatology of the coast”, will help coastal resource managers make better-informed decisions on a wide range of climatologically-influenced issues. The following sections outline the methodology employed to derive some new maps of coastal boundaries in the United States. (PDF contains 3 pages)

Value roadmapping: A structured approach for early stage technology investment decisions

Deciding to invest in early stage technologies is one of the most important tasks of technology management and arguably also the most uncertain. It assumes a particular significance in the rise of technology companies in emerging economies, which have to make appropriate investment decisions. Technology managers already have a wide range of methods and tools at their disposal, but these are mostly focussed on quantitative measures such as discounted cash flow and real options techniques. However, in the early stages of technology development there seems to be a lot of dissatisfaction with these techniques as there appears to be a lack of accuracy with respect to the underlying assumptions that these models require. In order to complement these models this paper will discuss an alternative approach that we call value road-mapping. By adapting roadmapping techniques the potential value streams of early stages technologies can be plotted and hence a clearer consensus based picture of the future potential of new technologies emerges. Roadmapping is a workshop-based process bringing together multifunctional perspectives, and supporting communication in particular between technical and commercial groups. The study is work in progress and is based on a growing number of cases. (c) 2006 PICMET.

Comparison of Image-Based and Time-of-Flight-Based Technologies for 3D Reconstruction of Infrastructure

Image-based (i.e., photo/videogrammetry) and time-of-flight-based (i.e., laser scanning) technologies are typically used to collect spatial data of infrastructure. In order to help architecture, engineering, and construction (AEC) industries make cost-effective decisions in selecting between these two technologies with respect to their settings, this paper makes an attempt to measure the accuracy, quality, time efficiency, and cost of applying image-based and time-of-flight-based technologies to conduct as-built 3D reconstruction of infrastructure. In this paper, a novel comparison method is proposed, and preliminary experiments are conducted. The results reveal that if the accuracy and quality level desired for a particular application is not high (i.e., error < 10 cm, and completeness rate > 80%), image-based technologies constitute a good alternative for time-of-flight-based technologies and significantly reduce the time and cost needed for collecting the data on site.

A Two-Tiered On-Line Server-Side Bandwidth Reservation Framework for the Real-Time Delivery of Multiple Video Streams

The advent of virtualization and cloud computing technologies necessitates the development of effective mechanisms for the estimation and reservation of resources needed by content providers to deliver large numbers of video-on-demand (VOD) streams through the cloud. Unfortunately, capacity planning for the QoS-constrained delivery of a large number of VOD streams is inherently difficult as VBR encoding schemes exhibit significant bandwidth variability. In this paper, we present a novel resource management scheme to make such allocation decisions using a mixture of per-stream reservations and an aggregate reservation, shared across all streams to accommodate peak demands. The shared reservation provides capacity slack that enables statistical multiplexing of peak rates, while assuring analytically bounded frame-drop probabilities, which can be adjusted by trading off buffer space (and consequently delay) and bandwidth. Our two-tiered bandwidth allocation scheme enables the delivery of any set of streams with less bandwidth (or equivalently with higher link utilization) than state-of-the-art deterministic smoothing approaches. The algorithm underlying our proposed frame-work uses three per-stream parameters and is linear in the number of servers, making it particularly well suited for use in an on-line setting. We present results from extensive trace-driven simulations, which confirm the efficiency of our scheme especially for small buffer sizes and delay bounds, and which underscore the significant realizable bandwidth savings, typically yielding losses that are an order of magnitude or more below our analytically derived bounds.

Randomized, controlled trial investigating short-term health-related quality of life with doxorubicin and paclitaxel versus doxorubicin and cyclophosphamide as first-line chemotherapy in patients with metastatic breast cancer: European Organization for Research and Treatment of Cancer Breast Cancer Group, Investigational Drug Branch for Breast Cancer and the New Drug Development Group Study.

PURPOSE: To compare health-related quality of life (HRQOL) in patients with metastatic breast cancer receiving the combination of doxorubicin and paclitaxel (AT) or doxorubicin and cyclophosphamide (AC) as first-line chemotherapy treatment. PATIENTS AND METHODS: Eligible patients (n = 275) with anthracycline-naive measurable metastatic breast cancer were randomly assigned to AT (doxorubicin 60 mg/m(2) as an intravenous bolus plus paclitaxel 175 mg/m(2) as a 3-hour infusion) or AC (doxorubicin 60 mg/m(2) plus cyclophosphamide 600 mg/m(2)) every 3 weeks for a maximum of six cycles. Dose escalation of paclitaxel (200 mg/m(2)) and cyclophosphamide (750 mg/m(2)) was planned at cycle 2 to reach equivalent myelosuppression in the two groups. HRQOL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 and the EORTC Breast Module at baseline and the start of cycles 2, 4, and 6, and 3 months after the last cycle. RESULTS: Seventy-nine percent of the patients (n = 219) completed a baseline measure. However, there were no statistically significant differences in HRQOL between the two treatment groups. In both groups, selected aspects of HRQOL were impaired over time, with increased fatigue, although some clinically significant improvements in emotional functioning were seen, as well as a reduction in pain over time. Overall, global quality of life was maintained in both treatment groups. CONCLUSION: This information is important when advising women patients of the expected HRQOL consequences of treatment regimens and should help clinicians and their patients make informed treatment decisions.

Can prospect theory explain risk-seeking behavior by terminally ill patients?

Patients with life-threatening conditions sometimes appear to make risky treatment decisions as their condition declines, contradicting the risk-averse behavior predicted by expected utility theory. Prospect theory accommodates such decisions by describing how individuals evaluate outcomes relative to a reference point and how they exhibit risk-seeking behavior over losses relative to that point. The authors show that a patient's reference point for his or her health is a key factor in determining which treatment option the patient selects, and they examine under what circumstances the more risky option is selected. The authors argue that patients' reference points may take time to adjust following a change in diagnosis, with implications for predicting under what circumstances a patient may select experimental or conventional therapies or select no treatment.

The trade unions membership dynamics and union members’ trajectories

This text presents an analysis of aggregated membership’s dynamics for Spanish trade unions, using ECVT data, as well as union memberships’ trajectories, or members’ decisions about joining the organization, permanency and responsibilities, and subsequent attrition. For the analysis of trajectories we make use of information of the records of actual memberships and the record of quitting of CCOO, and of a survey-questionnaire to a sample of leavers of the same union. This study allows us to confirm a linkage between the decision and motivations to become union member, to participate in union activities, the time of permanency, and the motives to quit the organization. We also identify five types of union members’ trajectories, indicating that, far from views that assert a monolithic structure, unions are complex organizations.